Epistaxis is a highly common occurring illness, whereby 10% of the population at one or another time point will obtain a nosebleed that requires treatment. One normally differs between local and general causes, whereby these may be combined.
The local causes are, in particular trauma (inter alia nose picking), flebektasises (vein knots) at the front of septum, and perforations; more rarely are tumors involved.
The general causes are in particular arterosklerosis, by hyper-tension, different conditions with increased bleeding tendency, as well as cataractic infections (influenza).
From a treatment point of view it is practical to differ between bleeds from the front part of the nose (epistaxis anterior) and bleeds from the rear or lower parts of the nose (epistaxis posterior).
At epistaxis anterior the bleeding spot can be observed directly and the bleeding can be inhibited by means of clamping of the nose, etching, electrical coagulation or direct tamponing. Treatment of this type of nosebleed is as a rule, uncomplicated and relatively painless and the treatment can be carried out by the patient self, a doctor on his own or a nursing center. It is seldom that the condition requires hospitalization of the patient.
Epistaxis posterior is often present in older patients and is much more difficult to treat. Hospitalization is quite often necessary. The bleeding spot is often hidden and can thus not be treated directly. The nose cavity has to be stuffed up carefully, which is often very unpleasant to the patient. The nose cavity shall be stuffed in a hard way until the patient has been free of bleeding for at least 24 hrs. The average hospitalization time for patients suffering from epistaxis posterior is about 4 days, of which 3 days with nose tamponing. Besides the direct discomfort as a consequence of the tamponing of the nose (lack of breathing ability through the nose and pain), mucous membrane necrosis and sinuitis closure are not rarely occurring complications during tamponing of the nose.
It has previously been proposed to rinse the interior of the nose with warm water, whereby the patient sits with his head slightly bent forward. Using a large syringe (200 ml) arranged on a nose adapter which closes against the nostril, the bleeding side of the nose is rinsed using water having a temperature of 48.degree. to 50.degree. C. until the bleeding has ceased. During the rinsing the water flows backwards and down into the pharynx and finally out through the mouth.
The treatment using warm water at nosebleed was first described by N. L. Gluice in 1884, whereby the treatment also has been disclosed as a routine treatment at posterior epistaxis by Oscar Bloch in "Noter til kliniske forelaesningar" (Notes to clinical lessons) 1907. The last time the treatment was mentioned as a possible alternative was in "Nordisk laerebog i ore-nase-hals-sygdomme" (Nordic text-book in ear-nose-throut-illnesses) 1958. During the later years the rinsing using warm water has only seldom been used as a treatment of nosebleed.
At department for ear-nose-and-throut-illnesses of the Gentofte amt hospital a prospective, random investigation of the value of "warm water rinse" compared to tamponing was initiated. The result was very promising, and beside proved less pain using a warm water rinse compared to tamponing, the mean hospitalization time was considerably shorter. The investigation was, however, finished before the planned finish due to problem with lack of co-operation from the patients concerning the warm water treatment.
The substantial problem using the hitherto known method has been the troublesome flow of water through the mouth in combination with a perturbation of the upper air ways.
It shall also be mentioned that within the medical-technical field there is a catheter, the so called Foley-catheter, which has an inflatable balloon in its front end, which catheter has been used for emptying the urine bladder, whereby the urine flows out through the forward open end of the catheter and the balloon has the task of holding the catheter in the bladder.
It would therefore be desirable to create an improved method for carrying out the treatment of a nosebleed.